SOUTH HEALTH CAMPUS

TITLE F AMILY P RESENCE AT S OUTH H EALTH C AMPUS

DOCUMENT # INITIAL APPROVAL DATE CSS–014G June 30, 2012

APPROVAL LEVEL INITIAL EFFECTIVE DATE Site Director, South Health Campus June 30, 2012

SPONSOR REVISION EFFECTIVE DATE Manager, Patient & Family Centred Care JUNE 1 2013

CATEGORY NEXT REVIEW Patient & Family Centred Care (Three years from approval/ revision date)

If you have any questions or comments regarding the information in this guideline, please contact the Manager of Patient & Family Centred Care.

PREAMBLE This guideline provides staff, physicians and volunteers with best practice information to achieve a care environment supportive of family presence at South Health Campus (SHC).

At SHC, it is recognized that family and friends are integral to the patient’s healing process. Family and primary support providers are welcomed as essential members of the health care team; they are not “visitors” in the lives of patients. At SHC, patients and families are full partners in care. In support of best practices in Patient & Family Centred Care (PFCC) a clear distinction is made at SHC between those who are “visiting” a patient and those persons who support and care for the patient. The existing Regional Policy–General Visiting # 1342 and visiting hours apply at SHC for “visitors” (see references).

Information and recommended processes have been developed in a collaborative method with key stakeholders including the Citizen Advisory Team, in developing the site wide procedures as related to supporting family presence. Best practice guidelines from within AHS, , the United States, and the United Kingdom were used to develop this guideline.

OBJECTIVES • To specifically differentiate between designated primary support persons/family members and visitors at the SHC • To ensure patients have the right to define “family/primary support persons” and designate who may “room–in” with them and/or be present to support them while receiving care and services at the SHC • To ensure practice of supporting family presence applies to both in–patient (acute care unit) and outpatient clinic services at SHC • To achieve a balance between the support provided by family/support persons, and the need for communication between the care team and the patient’s family/support persons, and the safety and well being of all patients and staff

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• To achieve a safe and supportive environment for patients, family and visitors • To support Patient & Family Centred Care principles of dignity and respect, information sharing, participation, and collaboration

APPLICABILITY This guideline applies to (AHS) employees, members of the medical and other professional staffs as well as students, volunteers, retail partners, other persons acting on behalf of Alberta Health services (AHS), and all SHC patients, family members and visitors.

GUIDELINES 1. Family Presence for Designated Family or Primary Support Persons 1.1 A family/primary support person (see definition) is/are defined and designated by the patient upon or prior to hospitalization. a) This may be one or two people. b) These people may change over time as specified by the patient. 1.2 Family/primary support persons is/are welcome to remain with the patient at all times–24 hours day, seven days per week. a) Patients, with the support and collaboration of the health care team, may choose which procedures/treatments/tests they want their family/primary support person to accompany them to/with. 1.3 Family/primary support person is/are, at the choice of the patient, welcomed and encouraged to participate in rounds. 1.4 Accompanied by a designated health care provider, family/primary support persons have the choice and are welcomed to remain with the patient at all times during a resuscitation code.

2. Rooming–In 2.1 A family and or primary support person is/are welcomed to spend the night with the patient, where space is adequate. (See 6. Infection Prevention and Control Considerations) 2.2 The support person must be able to safely stay alone and take care of his/her own care needs. a) They will be responsible for their own food and personal care items, and tidying their sleeping area. 2.3 Acute care unit staff will provide information to family/primary support persons regarding such comforts as use of patient washrooms, access to linens, family nourishment stations, and other amenities/services to support the family’s presence.

3. Noise & Disruptive Behaviour Family/primary support persons should be mindful and sensitive to the needs of other patients and families by keeping noise and disturbances to a minimum. 3.1 Disruptive behavior or unsafe practices are not accepted. 3.2 Should behavior become disruptive to any patient, family, staff or other visitor, or interfere with general comfort, care, care planning, or decision making of any

If you have any questions or comments regarding the information in this guideline, please contact the Manager of Patient & Family Centred Care at South Health Campus.

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patient, that persons may be asked to leave SHC by the care team and/or Protective Services.

4. Communication whiteboards at the bedside are an excellent example of how to best facilitate effective, safe and complete communication. 4.1 Patients and families are encouraged to document questions/concerns regarding daily needs, care goals and readiness for discharge.

5. Children under 14 years of age are welcomed to spend time with patients when accompanied by a responsible adult other than the patient. 5.1 Rooming–in of children under 14 years of age must be discussed in collaboration with the patient, family and health care team.

6. Family Presence in PACU (Post Anaesthesia Care Unit) may be arranged in consultation with the PACU Charge Nurse.

7. Infection Prevention and Control Considerations. SHC is responsible for protecting the health and safety of all patients, staff and visitors, and are committed to decreasing the risk of transmission of infectious diseases. 7.1 Family/primary support persons should NOT visit or room–in if they are feeling ill or have any of the following symptoms: Cough, runny nose, sore throat, fever, rash, diarrhea, nausea, or vomiting. 7.2 Visitors should NOT visit if they have a communicable disease or symptoms of a communicable disease, or have been exposed to a communicable disease for which they have no immunity. a) Visitors should call the nursing unit before visiting if they are unsure if they are contagious. 7.3 Hand Hygiene: Family/primary support persons should clean their hands both before and after visiting, after using the washroom, and before and after eating. a) Hand hygiene includes washing with soap and water, or applying alcohol-based hand rub (e.g. Microsan). 7.4 Patients on Isolation Precautions: In general, family and or support people cannot room–in when the patient is on isolation. a) Visiting is allowed and visitors will require instruction from the nursing staff on the putting on and taking off of Personal Protective Equipment (PPE), hand hygiene practices, and restrictions on the use shared spaces. b) Exceptions to isolation precautions for compassionate or emergent situations will require an infection control consultation in collaboration with the patient, family and the health care team.

DEFINITIONS This guideline specifically differentiates between visitors and family/primary support person.

If you have any questions or comments regarding the information in this guideline, please contact the Manager of Patient & Family Centred Care at South Health Campus.

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Patient • In Alberta Health Services, the term patient means all individuals including clients, residents and members of the public who receive or have requested health care or services from AHS and its health care providers.

Family/Primary Support Person • This is anyone identified by the patient as an important support who the patient wishes to be included in any encounters with the health care system, including but not limited to immediate and extended family members, friends, informal caregivers, etc.

Visitor • Refers to a guest of the patient and family, and can include friends, colleagues, or relatives who may wish to visit the patient or family.

Rooming–In • A practice which allows a family member or primary support person to share 24-hours-a -day accommodation, and remaining together as they would at home for any needed support.

REFERENCES • South Health Campus Guideline: Visiting Guidelines at South Health Campus http://insite.albertahealthservices.ca/shc/tms-shc-g-visiting.pdf • Regional Policy: General Visiting #1342. Classification: Quality Patient Care http://iweb9.calgaryhealthregion.ca/policydb/ShowPolicy?policy_id=1342 • Alberta Health Services Policy: Workplace Abuse and Harassment #SWE–02. Human Resources http://insite.albertahealthservices.ca/Files/cpd–pol–swe02–approved–workplace–abuse– and–harassment.pdf • Calgary Regional Infection Prevention & Control Manual http://www.albertahealthservices.ca/6854.asp • Calgary Health Region Postanesthesia Care Unit Manual: Patient Visitation in the Postanesthesia Care Unit (PACU) – PACU A–5 http://iweb.calgaryhealthregion.ca/surgicalservices/pacu_policies/A– 5_visiting_in_pacu.pdf

REVISIONS JUNE 1 2013

If you have any questions or comments regarding the information in this guideline, please contact the Manager of Patient & Family Centred Care at South Health Campus.